Facts About Uveitis | National Eye Institute Eye care professionals may also describe the disease as infectious or noninfectious uveitis. What is the Uvea and What Parts of the Eye are Most Affected by Uveitis? The uvea is the middle layer of the eye which contains much of the eye’s blood vessels (see diagram). This is one way that inflammatory cells can enter the eye. Located between the sclera, the eye’s white outer coat, and the inner layer of the eye, called the retina, the uvea consists of the iris, ciliary body, and choroid: Iris: The colored circle at the front of the eye. It defines eye color, secretes nutrients to keep the lens healthy, and controls the amount of light that enters the eye by adjusting the size of the pupil. Ciliary Body: It is located between the iris and the choroid. It helps the eye focus by controlling the shape of the lens and it provides nutrients to keep the lens healthy. Choroid: A thin, spongy network of blood vessels, which primarily provides nutrients to the retina.

Uveitis disrupts vision by primarily causing problems with the lens, retina, optic nerve, and vitreous (see diagram): Lens: Transparent tissue that allows light into the eye. Retina: The layer of cells on the back, inside part of the eye that converts light into electrical signals sent to the brain. Optic Nerve: A bundle of nerve fibers that transmits electrical signals from the retina to the brain. Vitreous: The fluid filled space inside the eye. Causes and Risk Factors What Causes Uveitis? Uveitis is caused by inflammatory responses inside the eye. Inflammation is the body’s natural response to tissue damage, germs, or toxins. It produces swelling, redness, heat, and destroys tissues as certain white blood cells rush to the affected part of the body to contain or eliminate the insult. Uveitis may be caused by: An attack from the body’s own immune system (autoimmunity). Infections or tumors occurring within the eye or in other parts of the body. Bruises to the eye. Toxins that may penetrate the eye. The disease will cause symptoms, such as decreased vision, pain, light sensitivity, and increased floaters. In many cases the cause is unknown.

Uveitis is usually classified by where it occurs in the eye. What is Anterior Uveitis? Anterior uveitis occurs in the front of the eye. It is the most common form of uveitis, predominantly occurring in young and middle-aged people. Many cases occur in healthy people and may only affect one eye but some are associated with rheumatologic, skin, gastrointestinal, lung and infectious diseases. What is Intermediate Uveitis? Intermediate uveitis is commonly seen in young adults. The center of the inflammation often appears in the vitreous (see diagram). It has been linked to several disorders including, sarcoidosis and multiple sclerosis. What is Posterior Uveitis? Posterior uveitis is the least common form of uveitis. It primarily occurs in the back of the eye, often involving both the retina and the choroid. It is often called choroditis or chorioretinitis. There are many infectious and non-infectious causes to posterior uveitis. What is Pan-Uveitis? Pan-uveitis is a term used when all three major parts of the eye are affected by inflammation.

Behcet’s disease is one of the most well-known forms of pan-uveitis and it greatly damages the retina. Intermediate, posterior, and pan-uveitis are the most severe and highly recurrent forms of uveitis. They often cause blindness if left untreated. Diseases Associated with Uveitis Uveitis can be associated with many diseases including: AIDS Redness of the eye Sensitivity to light (photophobia) Anyone suffering eye pain, severe light sensitivity, and any change in vision should immediately be examined by an ophthalmologist. The signs and symptoms of uveitis depend on the type of inflammation. Acute anterior uveitis may occur in one or both eyes and in adults is characterized by eye pain, blurred vision, sensitivity to light, a small pupil, and redness. Intermediate uveitis causes blurred vision and floaters. Usually it is not associated with pain. Posterior uveitis can produce vision loss. This type of uveitis can only be detected during an eye examination. How is uveitis detected? Diagnosis of uveitis includes a thorough examination and the recording of the patient’s complete medical history. Laboratory tests may be done to rule out an infection or an autoimmune disorder.

A central nervous system evaluation will often be performed on patients with a subgroup of intermediate uveitis, called pars planitis, to determine whether they have multiple sclerosis which is often associated with pars planitis. The eye exams used, include: An Eye Chart or Visual Acuity Test: This test measures whether a patient’s vision has decreased. A Funduscopic Exam: The pupil is widened (dilated) with eye drops and then a light is shown through with an instrument called an ophthalmoscope to noninvasively inspect the back, inside part of the eye. Ocular Pressure: An instrument, such a tonometer or a tonopen, measures the pressure inside the eye. Drops that numb the eye may be used for this test. A Slit Lamp Exam: A slit lamp noninvasively inspects much of the eye. It can inspect the front and back parts of the eye and some lamps may be equipped with a tonometer to measure eye pressure. A dye called fluorescein, which makes blood vessels easier to see, may be added to the eye during the examination. The dye only temporarily stains the eye. Uveitis Treatment How is Uveitis Treated?

Uveitis treatments primarily try to eliminate inflammation, alleviate pain, prevent further tissue damage, and restore any loss of vision. Treatments depend on the type of uveitis a patient displays. Some, such as using corticosteroid eye drops and injections around the eye or inside the eye, may exclusively target the eye whereas other treatments, such immunosuppressive agents taken by mouth, may be used when the disease is occurring in both eyes, particularly in the back of both eyes. An eye care professional will usually prescribe steroidal anti-inflammatory medication that can be taken as eye drops, swallowed as a pill, injected around or into the eye, infused into the blood intravenously, or, released into the eye via a capsule that is surgically implanted inside the eye. Long-term steroid use may produce side effects such as stomach ulcers, osteoporosis (bone thinning), diabetes, cataracts, glaucoma, cardiovascular disease, weight gain, fluid retention, and Cushing’s syndrome. Usually other agents are started if it appears that patients need moderate or high doses of oral steroids for more than 3 months.

Other immunosuppressive agents that are commonly used include medications such as methotrexate, mycophenolate, azathioprine, and cyclosporine. These treatments require regular blood tests to monitor for possible side effects. In some cases, biologic response modifiers (BRM), or biologics, such as, adalimumab, infliximab, daclizumab, abatacept, and rituximab are used. These drugs target specific elements of the immune system. Some of these drugs may increase the risk of having cancer. Anterior Uveitis Treatments Anterior uveitis may be treated by: Taking eye drops that dilate the pupil to prevent muscle spasms in the iris and ciliary body (see diagram). Taking eye drops containing steroids, such as prednisone, to reduce inflammation. Intermediate, Posterior, and Pan-Uveitis Treatments Intermediate, posterior, and pan-uveitis are often treated with injections around the eye, medications given by mouth, or, in some instances, time-release capsules that are surgically implanted inside the eye. Other immunosuppressive agents may be given.

A doctor must make sure a patient is not fighting an infection before proceeding with these therapies. A recent NEI-funded study, called the Multicenter Uveitis Treatment Trial (MUST), compared the safety and effectiveness of conventional treatment for these forms of uveitis, which suppresses a patient’s entire immune system, with a new local treatment that exclusively suppressed inflammation in the affected eye. Conventionally-treated patients were initially given high doses of prednisone, a corticosteroid medication, for 1 to 4 weeks which were then reduced gradually to low doses whereas locally-treated patients had a capsule that slowly released fluocinolone, another corticosteroid medication, surgically inserted in their affected eyes. Both treatments improved vision to a similar degree, with patients gaining almost one line on an eye chart. Conventional treatment produced few side effects. In contrast, the implant produced more eye problems, such as abnormally high eye pressure, glaucoma, and cataracts. Although both treatments decreased inflammation in the eye, the implant did so faster and to a greater degree. Nevertheless, visual improvements were similar to those of patients given conventional treatment. Current Research What Research is Being Done?

The National Eye Institute conducts and supports a number of studies investigating uveitis, including: Testing new methods for treating uveitis. Investigating the possible causes of uveitis. Learning who is most susceptible to the disease. This research should provide better ways to detect, treat, and prevent uveitis. This guide provides information about uveitis. It answers questions about its causes and symptoms, and discusses diagnosis and types of treatment. It was adapted from the following sources: Durrani OM, Meads CA, Murray PI: Uveitis: A Potentially Blinding Disease, Ophthalmologica 218: 223-236, 2004. Jabs DA, Nussenblatt RB, Rosenbaum JT, and Standardization of Uveitis Nomenclature (SUN) Working Group: Standardization of Uveitis Nomenclature for Reporting Clinical Data. Results of the First International Workshop, Am J Ophthalmology 140(3): 509-16, 2005.

Uveitis | RNIB | Supporting people with sight loss Uveitis Uveitis Find out more about Uveitis - a swelling of the part of the eye called the uvea About uveitis Uveitis is an eye condition where there is inflammation (swelling) in a part of your eye called the uvea. Uveitis affects different people in different ways depending on which part of the uvea is affected. The symptoms of uveitis may include pain, sensitivity to bright lights and poor vision. Most cases of uveitis get better with treatment. Some types of uveitis are more difficult to treat and may cause more permanent changes to your vision. Around two to five in every 10,000 people are affected by uveitis in the UK every year. Uveitis affects people of any age, but most commonly between the ages of 20 and 59 years. Some children develop uveitis. Your eyeball has three layers, the outer tough coating which is the white of the eye, the innermost light sensitive layer called the retina and a middle layer called the uvea.

Your uvea is made up of your: iris – the coloured part of the eye which controls the amount of light entering your eye ciliary body – the circular band of tissue behind the iris which produces the internal fluid of the eye choroid – a layer of pigmented tissue and blood vessels which supply your retina. Your retina can also be affected in uveitis. What are the different types of uveitis? Uveitis is described in different ways depending which part of your uvea is affected: Anterior uveitis is when the iris or ciliary body at the front of your eye is affected (sometimes called iritis). Intermediate uveitis is when the area behind your ciliary body is affected, with most of the inflammation being seen in the vitreous, the jelly-like substance that fills your eye. Posterior uveitis affects the choroid (choroiditis) or retina (retinitis) or both. It can also affect the optic nerve head, where the nerve fibres leave your eye for the brain. There are many types of posterior uveitis including Birdshot chorioretinopathy or Punctate Inner Choroidopathy (PIC).

Panuveitis is where the inflammation affects the whole uvea. Uveitis may also be described depending on how long it lasts: Acute: when your uveitis starts suddenly but improves within 3 months. Recurrent: when the inflammation flares up and settles down over months and years. Anterior uveitis is usually recurrent with acute episodes. Chronic: when the inflammation is longer lasting and also comes back within 3 months of stopping treatment. Intermediate and posterior types of uveitis are usually chronic. What causes uveitis? There are a number of different causes for uveitis, these include: Auto-immune and Inflammatory conditions Uveitis may develop in people who have an underlying autoimmune condition (where the immune system mistakenly attacks healthy tissue). Often in uveitis, the inflammation only affects the inside of your eye, but sometimes it may be connected with an inflammatory condition elsewhere in your body. You may or may not know that you have another inflammatory condition at the time the uveitis first develops. About 50% of people with anterior uveitis have a gene called HLA-B27.

This gene is found in people with certain auto-immune conditions including: ankylosing spondylitis People with one of these conditions have an increased chance of developing anterior uveitis. Other inflammatory conditions are also more prone to developing uveitis: Chronic anterior uveitis in children may be associated with juvenile arthritis Intermediate uveitis can be associated with sarcoidosis or multiple sclerosis Posterior uveitis can be associated with Behcet’s disease or sarcoidosis Infections Uveitis can be caused by viral, bacterial or parasitic infections. Examples can include: Virus – herpes simplex (cold sores), herpes zoster (chickenpox and shingles), or cytomegalovirus Bacteria – tuberculosis or syphilis Parasites – toxoplasmosis Many of these infections which cause uveitis are more likely in patients with poorly active or suppressed immune systems. This includes patients who have had organ transplants, leukaemia or HIV and AIDS. Injury An injury to your eye can cause uveitis in that eye. A very severe injury can even trigger the immune system to cause uveitis in the other eye, known as sympathetic ophthalmia.

This is very rare and only an injury through the eyeball wall, needing an operation to repair, can lead to sympathetic ophthalmitis. Idiopathic Sometimes it may not be possible to work out what the cause of your uveitis is. This is called ‘idiopathic’ and means that it is not clear what the cause is, and that no other cause can be found. It’s thought that most of these cases may be autoimmune but this cannot be confirmed. Anterior Uveitis (Iritis) The most common type of uveitis is anterior uveitis. What are the symptoms of anterior uveitis? The symptoms of anterior uveitis usually start over hours or days and usually only affect one eye at a time. It typically causes eye pain, eye redness and sensitivity to light (photophobia). The eye pain is often aching and the eyeball feels tender. Vision may be slightly blurred. When symptoms like this occur, it’s important to have your eyes checked straight away either by the optician or by the hospital. How is anterior uveitis diagnosed?

Anterior uveitis is usually diagnosed by an ophthalmologist (eye specialist) using a piece of equipment called a slit-lamp, which consists of a microscope and a powerful bright beam of light. It allows them to check for signs of inflammation. What is the treatment for anterior uveitis? For most people with anterior uveitis a course of eye drops is all the treatment needed to clear up the inflammation. Steroid eye drops Corticosteroid eye drops are used to reduce the inflammation at the front of the eye. Depending on the level of inflammation, the dose can range from using the eye drops every hour to using them just once a day. As the inflammation gets better, the dose will be reduced slowly by your ophthalmologist. It’s important to not stop using your eye drops until your ophthalmologist advises you that it is safe to do so, even if your symptoms disappear, as stopping your treatment too soon can cause the inflammation to return. Using steroid eye drops in the short term doesn’t normally cause many side effects. While you’re on steroid drops your resistance to eye infections will be reduced. Since wearing contact lenses may encourage infection, you’re usually advised against wearing these during your treatment.

If steroid eye drops are used for long periods of time, they can lead to raised eye pressure (glaucoma).High doses for long periods of time can lead to clouding of the lens (cataract), particularly in children. If your uveitis is treated for a number of months then your ophthalmologist will monitor your eye for these complications. Cycloplegic or mydriatic eye drops Cycloplegic or mydriatic eye drops are given for anterior uveitis in addition to steroid medication. These drops relieve the pain by paralysing the muscles of your iris and ciliary body as it is the movement of these inflamed muscles that cause the pain. The drops also dilate your pupils and are used to reduce the risk of your iris sticking to your lens (known as synechiae). A synechiae can lead to raised pressure in your eye and cause glaucoma. These drops can cause some temporary blurring of your vision and problems focusing. You may also become more sensitive to the light as they make your pupil larger. Wearing dark sunglasses can make your eyes feel more comfortable and help with problems of glare during this period.

Once you stop taking these drops your pupil should react normally to light. Treating Infection If your uveitis is caused by an infection, the infection will need to be treated with antiviral or antibiotic eye drops too. What happens in the long term with anterior uveitis? An episode of acute anterior uveitis which has been treated promptly doesn’t usually cause any long term changes to your sight. This is because it responds quickly to treatment so only a short course of eye drops is needed and most people recover within a few weeks. Some people will only ever have a single episode of anterior uveitis. However, it can recur or become chronic in which case it may cause more problems over time. Some people who have recurrent uveitis learn to recognise their symptoms. Unfortunately there is little you can do to prevent recurrences in either eye. The best thing is to recognise that it can recur and so get the inflammation treated as quickly as possible to prevent complications. Intermediate and Posterior uveitis Intermediate uveitis is most commonly seen in young adults. Posterior uveitis is the least common form of uveitis. What are the symptoms of intermediate and posterior uveitis?

Intermediate uveitis can cause floaters (shapes, dots and wispy lines that move across your vision). It usually affects both of your eyes. Your vision may gradually feel more blurry and occasionally you may be sensitive to light. Some people with intermediate uveitis may also get anterior uveitis. Posterior uveitis causes blurry, distorted vision or patchiness or gaps in your vision. It can also cause problems with colour or night vision. Intermediate or posterior uveitis doesn’t usually cause any eye pain or redness. They’re usually more chronic, lasting months or years, with a tendency to flare up at times. Both eyes are usually affected but not always at the same time or to the same degree. The condition may be present for quite some time before it is diagnosed because you may not be aware of any problem. How are intermediate and posterior uveitis diagnosed? There’s a wide range of causes of uveitis and many medical conditions can be associated with it. Your eye examination shows which part of your eye is inflamed but doesn’t show what has caused the inflammation. Your ophthalmologist may want to do further tests to identify the cause, which may include blood tests or X-rays of your chest.

Although these extra tests may not seem connected to your eye problem, they’re important in finding out the cause of your uveitis. This will help plan the correct treatment for you, give you an idea about how it may develop, and find any connection with a condition elsewhere in the body. If another condition is discovered you may be referred to see a specialist in that condition. Some more specialist eye tests you may have can include: Fluorescein angiography. This is a way of looking at the circulation of your retinal blood vessels and find out how much of your retina is being affected by the inflammation. A yellow dye is injected into your arm, which travels through the bloodstream to your eye which allows the ophthalmologist to check for any circulation problems. Indocyanine green angiography (ICG) is a similar test to fluorescein angiography but a different type of dye is used. Optical Coherence Tomography (OCT) scans your retina to check for swelling and inflammation. Electroretinogram (ERG) is a test to check how well the light- sensitive cells of your retina are working.

If an infection in your eye is suspected as a cause for your uveitis, the ophthalmologist may take a sample of fluid from inside your eye to look for this. This can be done with local anaesthetic eye drops in the eye clinic. Specific types of posterior uveitis Birdshot chorioretinopathy Birdshot chorioretinopathy is a type of chronic posterior uveitis, which can last a long time and the inflammation can often flare up and down. It’s thought to be an autoimmune condition which affects the eyes only. The onset of the condition is usually gradual and in the initial stages, you may be able to continue to see well but may have problems with night vision and colour vision, and be sensitive to bright lights. How Birdshot chorioretinopathy affects vision in the long term can be very varied. People with milder forms of Birdshot can often maintain good sight with little or no treatment. However, more severe cases can be difficult to treat and cause complications which can lead to changes in your sight. The Birdshot Uveitis Society (BUS) can offer more information about this specific type of uveitis and can also provide support to those affected.

Punctate Inner Choroidopathy Punctate inner choroidopathy (PIC) is a rare form of posterior uveitis which tends to affect mainly women who are short-sighted, but why people develop PIC is not fully understood. Symptoms can include blurred vision, ‘blind spots’ in your vision and seeing flashing lights. Often, the inflammation in PIC can resolve on its own and it doesn’t always require treatment. However treatment is given if there are many active or central areas of inflammation. People with PIC and some other forms of posterior uveitis can develop a complication where there is growth of new vessels in the choroid (choroidal neovascularisation). These new vessels are weak and leaky which causes swelling and bleeding of the retina and can lead to scarring and sight loss. Treatment will usually be aimed at controlling the inflammation as well as treating any new blood vessel growth. What are the treatments for intermediate and posterior uveitis? Treatment for uveitis can differ from person to person quite considerably and will also take into account the cause of your uveitis. Steroid medication Apart from certain types of uveitis caused by infection, steroid medication (corticosteroids) is the mainstay of treating uveitis.

Corticosteroids work by reducing the activity of your immune system so that it no longer releases the chemicals which cause inflammation. Injections or implants Injections are used for intermediate or posterior uveitis to deliver the steroid to the parts of the eye that are inflamed. Steroids can be injected into the eye either as a liquid or small implant to treat non-infectious uveitis. The injections and implants are usually given if only one eye requires treatment and can be given around the eye or into the eye. An injection given to your eye may be a scary thought, but most people experience only mild discomfort because local anaesthetic eye drops are used to numb the eye beforehand. An implant which is like a thin grain of rice can be injected inside your eye. The steroid medication is released slowly from this implant and lasts between 3-6 months. Oral medicine Tablet corticosteroids are usually given if injections or implants haven’t been successful in controlling the inflammation, or if the uveitis is affecting more posterior parts of your eye. How long you’ll need to take tablet corticosteroids will depend on how well your uveitis responds to treatment and whether you have an underlying autoimmune condition.

Some people may only need a three to six week course, while others need to have a course lasting months or possibly years. Oral corticosteroids work well in relieving inflammation, but can cause side effects. These can include weight gain, mood changes (feeling irritable or anxious), osteoporosis (fragile bones), stomach ulcers or diabetes. Most of these side effects will be monitored, using blood or urine tests, measuring blood pressure and weight etc, but if you are concerned about any side effects, you should ask your GP. You may require additional medications to prevent stomach ulcers or osteoporosis. Although steroids can cause side effects, the threat to sight in the long term is worse if uveitis is not treated properly. Your ophthalmologist will usually start with a higher dose and once the inflammation is controlled bring the dose down to a level with fewer side effects but enough to keep the inflammation settled. It’s important to not stop taking your medication suddenly. If your ophthalmologist decides you no longer need treatment, they’ll reduce the dose of your medication gradually.

Immunosuppressants Immunosuppressant medication may be recommended if uveitis doesn’t respond to other treatments or to allow the dose of steroids to be reduced if they are causing you significant side effects. In some types of uveitis, the systemic condition needs to be treated with this medication as much as the eyes do. Taking immunosuppressant drugs will make you more vulnerable to infections, so you should avoid close contact with anyone who has a known infection. You should also report any symptom of a potential infection, such as high temperature or cough, to your doctor. If you attend any health centre, either as an emergency or for a routine procedure or operation, you should tell the doctors or nurses looking after you that you are taking immunosuppressants. Treating Infection If your uveitis is caused by an infection, the infection will need to be treated with antiviral or antibiotic tablets too. Surgery In rare cases, surgery may be needed to treat uveitis. However, this is usually only used if you have repeated or severe uveitis that affects the back of your eye. An operation called a vitrectomy to remove the vitreous (jelly that fills the eye) may be used.

This jelly will be removed and temporarily replaced during the operation with either a bubble of gas or a liquid substitute. Eventually, your eye will naturally replace the vitreous with a slightly different clear fluid called aqueous humour. If your uveitis isn’t responding to treatment or your ophthalmologist suspects that there is something else behind the uveitis, they may want to get a sample of the vitreous to test for infection or tumours. Newer treatments Some newer treatments for uveitis are being investigated which may be helpful in cases of severe or chronic posterior uveitis where other treatments haven’t worked. Several studies are looking at using anti-TNF drugs. In people with certain inflammatory conditions, a protein called TNF is overproduced in the body, causing inflammation. Anti-TNF drugs block the action of TNF and so can reduce this inflammation. Anti-TNF drugs are used and licensed for certain rheumatic conditions but aren’t yet licensed for use in uveitis. The results of the studies may lead to these treatments being more routinely available. What happens in the long term with intermediate and posterior uveitis?

The way in which your sight may be affected in the long term by intermediate/posterior uveitis may be due to the direct effects of the uveitis or its complications. Uveitis affecting the back of your eye tends to heal more slowly so more prolonged treatment is likely to be necessary. The time for a response to treatment, how long a flare up lasts and how vision is affected in the short and long-term really varies from person to person. If you have chronic or recurrent uveitis you will usually be under the long-term care of an ophthalmologist and will have regular checkups in the outpatient clinic. Certain types of uveitis are uncommon and require specialist care. You may therefore be referred by your local ophthalmologist to a specialist eye department and need to travel further for our appointments. This is necessary in order to have the specialist care and treatment, however once the uveitis is controlled you may be able to be referred back to your local eye department. What are the complications of uveitis? Uveitis needs to be treated promptly to try to reduce the risk of further problems that might affect your sight. Good control of inflammation can be achieved in most people and this reduces the risk of developing complications.

The treatments that are used for uveitis can have side-effects (and may need monitoring), but controlling the uveitis properly with treatments will generally give a better outcome for your sight than ‘under-treating’ and allowing the uveitis to continue. Some of the complications uveitis can cause include: Raised eye pressure Untreated anterior uveitis can slow down the drainage of fluid within the eye causing the pressure in the eye to rise. If not detected, monitored or treated this raised pressure causes damage to your optic nerve (made up of nerve cells carrying light signals to the brain), resulting in glaucoma. Your ophthalmologist will check your eye pressure when you attend the eye clinic. Untreated anterior uveitis can also cause parts of the iris to stick to the front surface of the lens (known as posterior synechiae). If this progresses to involve the whole iris it prevents fluid draining through the pupil and increases your eye pressure. This can cause your vision to be misty and halos to appear around lights. Cycloplegic or mydriatic eye drops which cause the pupils to dilate are given to people with anterior uveitis to help to prevent a synechiae.

Using steroids can also cause an increase in eye pressure for some people. At least 5% of the population are “steroid eye pressure responders”, meaning that the eye pressure goes up when steroids are used. Your ophthalmologist will determine whether you fall into this group and may prescribe eye drops to lower your eye pressure. Macula oedema Macula oedema can affect some people with chronic uveitis or uveitis that affects the back of the eye. Prolonged inflammation can result in a build up of fluid inside the central part of the retina (the macula). This can affect your central vision and you may notice blurriness, distortion, or a black spot in the central part of your vision. Macula oedema can be treated using corticosteroid injections or tablets. In most cases, vision can improve with treatment particularly if it’s treated early. However, this isn’t always the case in severe or prolonged cases of macula oedema, and it’s one of the main causes of sight loss in people with uveitis. Your central vision can be affected by macula oedema and can cause difficulty in recognising faces, reading and watching television. Straight lines may appear wavy or distorted.

Detecting movement in your side vision is not affected with macula oedema so getting around is generally not a problem. Cataract The inflammation inside the eye can sometimes cause cloudiness of the lens. This cloudiness is called a cataract and can cause symptoms such as blurred or misty vision, colours appearing dull, or problems seeing clearly at night. Cataracts can also be caused by long term steroid treatment (over years), but this has much less of an effect on sight than under-treating the uveitis would. Cataracts can be treated using surgery to remove the affected lens and replace it with an artificial one. Floaters Floaters are seen as black dots or wispy lines floating across your vision as a result of clumps or cells in the vitreous. General haziness can occur if there is active inflammation and inflammatory cells in the vitreous or anterior chamber. Light sensitivity can make bright light uncomfortable. Using sunglasses, tinted lenses and sunshields can help to reduce the discomfort and glare you may experience in everyday living. Retinal detachment In posterior uveitis, the inflammation can cause fluid to collect under your retina so that it comes away or is detached from the back of the eye.

Alternatively the inflammation can cause pulling on the retina or a hole to develop in the retina leading to retinal detachment. This is uncommon and tends to occur in specific types of posterior uveitis including certain infections. Retinal detachment can cause you to experience flashing lights in your vision, or a shadow in the corner of your vision which does not go away and may progress to come across your vision. It’s important to seek attention that day if you suspect having a retinal detachment as if left untreated can cause permanent loss of sight. Coping It’s completely natural to be upset when you have been diagnosed with uveitis and it’s normal to find yourself worrying about the future and how you will manage with a change in your vision. It can sometimes be helpful to talk over some of these feelings with someone outside your circle of friends or family. At RNIB, we can help with our telephone Helpline and our Emotional Support service . You may also find your GP or social worker can help you find a counsellor if you feel this might help you. Can I get help to see things better? In whatever way the uveitis has affected your sight, there are lots of things you can do to make the most of your vision.

If uveitis has affected your sight then ask your ophthalmologist, optometrist or GP about low vision aids, like a magnifier, and ask for a referral to your local low vision service. You should also ask whether you are eligible to register as sight impaired (partially sighted) or severely sight impaired (blind). Registration can act as your passport to expert help and sometimes to financial concessions. Even if you aren’t registered a lot of this support is still available to you. Local social services should also be able to offer you information on staying safe in your home and getting out and about safely. They should also be able to offer you some practical mobility training to give you more confidence when you are out. Our Helpline can also give you information about the low vision services available, and our website offers lots of practical information about adapting to changes in your vision and products that make everyday tasks easier. What support is available? Whether you have just been diagnosed with uveitis or have been living with it for a while, at RNIB, we are here to help and support you at every step.

Royal National Institute of Blind People (RNIB) 105 Judd Street London WC1H 9NE The RNIB Helpline is your direct line to the support, advice and products you need. We'll help you to find out what's available in your area and beyond, both from RNIB and other organisations. Whether you want to know more about your eye condition, buy a product from our shop, join our library, find out about possible benefit entitlements, be put in touch with a trained counsellor, or make a general enquiry, we're only a call away. RNIB Helpline Email: helpline@rnib.org.uk We’re ready to answer your call Monday to Friday 8.45am to 5.30pm. Outside these times leave us a message and we'll get back to you as soon as possible. Uveitis Information Group Uveitis Guide: Causes, Symptoms and Treatment Options Q & A What Is It? Uveitis means inflammation of the part of the eye called the uvea. The uvea, also called the uveal tract, is a continuous layer of fibrous tissue that surrounds the eye.

It is made up of three structures: The iris — The donut-shaped part that gives the eye its color The choroid — A membrane full of tiny blood vessels that lines the eye The ciliary body — A thick ring of tissue that helps control the shape of the lens, and is attached to the iris and to the front portion of the choroid Various terms are used for the condition, depending on the part of the uvea affected. They include: Anterior uveitis (iritis) — Affects the front portion of the uvea, the iris Iridocyclitis — Affects the iris and the ciliary body Intermediate uveitis (also called pars planitis) — Affects the middle portion of the uvea, between the retina and the ciliary body Posterior uveitis (choroiditis) — Affects the back part of the uvea, the choroids Diffuse uveitis — Inflammation of all portions of the uvea The most common types of uveitis are anterior uveitis and iridocyclitis. Posterior uveitis is rare.

Many cases of uveitis are related to an autoimmune disorder (such as ankylosing spondylitis, lupus, juvenile rheumatoid arthritis, multiple sclerosis or sarcoidosis) or an infection, such as tuberculosis, toxoplasmosis, herpes, syphilis or cytomegalovirus (especially in patients with AIDS). A number of conditions, including pars planitis, birdshot choroidopathy and sympathetic ophthalmia, are diseases of the eye that may cause uveitis but usually do not affect other parts of the body. Rarely, uveitis occurs as a side effect of a medication. In up to half of cases, the cause is not known, but recent research has linked certain genes to the development of the disease. One possibility is that some people are prone to uveitis because they have genes that program the immune system to attack the uvea, a process that may be triggered by an infection. Symptoms Symptoms of uveitis can vary depending on the location of the inflammation.

Severe symptoms generally are associated with anterior uveitis, and can include: Eye pain Sensitivity to light Blurred or decreased vision Intermediate and posterior uveitis can have more subtle symptoms, including small specks or clouds that move in your field of vision, called floaters, and decreased vision. Diagnosis If your physician suspects you have uveitis, you are likely to be referred to an ophthalmologist (eye specialist), who will give you a thorough eye exam, including: Tests of visual acuity, to determine if vision has decreased. This can be as simple as reading an eye chart. A funduscopic exam, in which the pupil is dilated (widened) so that the ophthalmologist can look into the eye and see structures at the back of the eye. Measures of the pressure inside the eye to make sure it has not reached high levels that might be dangerous. This painless test involves an instrument called a tonometer that either blows a puff of air or lightly presses on the surface of the eye and measures how the surface of the eye responds. A slit-lamp exam, in which a narrow beam of light is shone into the eye so that a magnifying lens can closely examine the highlighted portion of the eye.

Your doctor will use eye drops to dilate the pupil of the eye. A drop of fluorescein dye may be placed in the eye. This dye temporarily stains the surface of the eye and can help to determine which layers of the eye are inflamed. In addition, your physician probably will ask you about your medical history, and will examine you. Depending on the results, he or she may order blood tests and X-rays (such as a chest X-ray to look for evidence of sarcoidosis). Because uveitis often is associated with a viral infection or an autoimmune disease, other conditions need to be discovered and treated as well. Expected Duration With treatment, most people with uveitis will improve within days or weeks. However, the condition may last several months. Chronic (long-term) forms of the disease can be very difficult to cure, and may return. If you have been treated successfully for uveitis, you should expect to have follow-up visits to your doctor every one to six months to make sure that the disease remains stable. Prevention Other than avoiding certain infections, including syphilis or HIV, there is no way to prevent uveitis. Treatment Treatment of uveitis focuses on reducing inflammation and relieving pain.

If you have an infection, your doctor will prescribe antibiotics. For noninfectious uveitis, treatment will usually include prescription eye drops or ointments containing corticosteroids to reduce inflammation. If uveitis affects the iris, eye drops that dilate the pupil also may be prescribed so that the iris won't move and cause pain. Your doctor may recommend sunglasses because bright light may cause discomfort. For more severe cases, your ophthalmologist may recommend injections of corticosteroids into the eye, oral forms of corticosteroids or additional immunosuppressive medications. Examples of immunosuppressive therapies used in the treatment of uveitis include methotrexate , azathioprine , and mycophenolate mofetil . More recently, options available to treat people with severe uveitis that does not respond to other therapies include adalimumab (injected under the skin or steroid implants surgically inserted into the eye. Any complications of uveitis, such as glaucoma or cataracts, also will need to be treated.

For many patients, a team of physicians will be involved, including a general medical physician, an ophthalmologist, and sometimes other specialists (for example, infectious disease or arthritis experts). When To Call A Professional See your health care professional if you experience blurred vision, pain in one or both eyes, sensitivity to light, or eye redness. Prognosis The outlook varies, depending on the type of uveitis, its severity and duration, whether it responds promptly to treatment and whether there is an associated illness. When diagnosed and treated promptly, the prognosis is generally good, and patients can expect to recover eventually. Left untreated, the complications of uveitis can be serious, and may include glaucoma, cataracts or permanent loss of vision. Learn more about Uveitis Uveitis: MedlinePlus Medical Encyclopedia URL of this page: //medlineplus.gov/ency/article/001005.htm Uveitis Uveitis is swelling and irritation of the uvea , the middle layer of the eye. The uvea provides most of the blood supply to the retina . Causes Uveitis can be caused by autoimmune disorders , including rheumatoid arthritis or ankylosing spondylitis .

It can also be caused by infection or exposure to toxins. In many cases, the cause is unknown. The most common form of uveitis is anterior uveitis. This involves inflammation in the front part of the eye. It is often called iritis because it usually only affects the iris, the colored part of the eye. The inflammation may be linked with autoimmune diseases, but most cases occur in healthy people. The disorder may affect only one eye. It is most common in young and middle-aged people. Posterior uveitis affects the back part of the uvea. It involves primarily the choroid , which is a layer of blood vessels and connective tissue in the middle part of the eye. This type of uveitis is called choroiditis. If the retina is also involved, it is called chorioretinitis. You may develop this condition if you have had a body-wide ( systemic ) infection or if you have an autoimmune disease. Another form of uveitis is pars planitis. This inflammation affects the narrowed area (pars plana) between the colored part of the eye (iris) and the choroid. Pars planitis most often occurs in young men. It is generally not associated with any other disease.

However, it may be linked to Crohn's disease and possibly multiple sclerosis. Uveitis can be associated with any of the following: What Causes Uveitis? | Prevent Blindness What Causes Uveitis? Causes of Uveitis Uveitis is inflammation of the eye’s uvea. Inflammation is the body’s response to injury, or trauma. To treat uveitis, doctors look for the cause of the trauma to the eye. Uveitis can be caused by many different kinds of trauma, including a virus, bacteria infections, or parasites. Genes can play an important role in uveitis. Also, diseases that damage the body’s immune system, such as AIDS, can lower the body’s ability to protect itself from infections that can cause uveitis. In many cases, perhaps as many as a third or half of all uveitis cases, the cause of the inflammation is not known. Causes of Anterior Uveitis In more than a third of all cases of anterior uveitis, the exact cause is unknown. Causes may include: Ankylosing spondylitis is a type of arthritis that mainly affects the spine. This can cause recurrent arthritis.

Reiter’s syndrome is an inflammatory arthritis common in young men – often caused by chlamydia infection. Psoriatic arthropathy is a form of arthritis that nearly a quarter of people with psoriasis may develop. It causes pain, swelling and stiffness in joints. Psoriasis is an immune-related disease of the skin and joints. Inflammatory bowel disease causes inflammation, ulcers and scarring to the wall of the intestine but can affect other parts of the body as well. Juvenile rheumatoid arthritis (JRA) is a kind of arthritis (inflammation of the joints) in children, affecting more than 75,000 children in the U.S. Uveitis is the most common eye problem that can develop in children with JRA. Children with JRA may get uveitis before JRA is even diagnosed, or it can occur many years later. Herpes is a common viral infection that causes oral or genital herpes. It mostly affects only one eye, but it can cause recurrent uveitis. Sarcoidosis is a kind of inflammation that can affect many parts of the body. Its cause is unknown. Fuch’s heterochromic iridocyclitis is a chronic kind of iritis.

Its cause is unknown. It may cause rapid increase in eye pressure, requiring immediate treatment. Lupus is a chronic inflammatory disease that affects different parts of the body, including the skin, joints, blood, and kidneys and is related to the body’s immune system. Intraocular lens surgically implanted to replace a cataract lens. Uveitis can be caused by trauma related to cataract surgery. In cataract surgery, the eye’s natural lens is removed and replaced with an artificial (plastic) lens. The presence of this artificial lens can cause anterior uveitis. Posner-Schlossman syndrome (PSS) is an uncommon inflammatory eye condition that usually affects one eye at a time. It typically affects young to middle-aged adults who develop high pressure inside the eye and mild inflammation. Rheumatoid arthritis is a chronic inflammation of the joints that can cause permanent joint damage and disability. Syphilis is a sexually transmitted disease. It can be cured, but if left untreated, the late stages of the disease can cause heart problems, abnormalities, mental illness, blindness and death. Although on the decline over the past decade, it has seen more cases in recent years.

Tuberculosis (TB) is a disease caused by bacteria that usually attacks the lungs. TB disease was once the leading cause of death in the United States. It is spread through the air from one person to another. Although treatable, TB is still a problem in the U.S. Lyme disease is a disease caused by bacteria that are transmitted to people from the bite of a deer tick. It often causes a "bull's-eye" rash around the bite, with symptoms such as fever, tiredness, headache, muscle and joint aches. Causes of Intermediate Uveitis In more than two thirds of all cases of intermediate uveitis, the exact cause is unknown. The remaining third of all cases are thought to be caused by conditions such as: Sarcoidosis, a kind of inflammation that can affect many parts of the body. Its cause is unknown. MS (multiple sclerosis) an inflammatory disease that affects the brain and spinal cord Lyme disease, a disease caused by bacteria that are transmitted to people from the bite of a deer tick. It often causes a "bull's-eye" rash around the bite, with symptoms such as fever, tiredness, headache, muscle and joint aches.

Causes of Posterior Uveitis Following is a list of common causes of posterior uveitis. In more than one in ten cases of uveitis, however, the exact cause is unknown. Toxoplasmosis is an infection caused by a parasite. It affects up to one fifth of all adults in America. People may become infected from eating raw or undercooked meats, drinking unpasteurized milk, cleaning cat litter boxes, or working in gardens or playing in sandboxes that contain cat feces. Cytomegalovirus retinitis (CMV retinitis) is a serious eye infection of the retina. It is a threat to people with weak immune systems, such as people with HIV, people undergoing chemotherapy, and people who have had organ transplants. Without treatment, CMV retinitis can destroy the retina and damage the optic nerve, resulting in blindness. Lupus is a chronic inflammatory disease that affects different parts of the body, including the skin, joints, blood, and kidneys and is related to the body’s immune system. Birdshot retinochoroidopathy may be an autoimmune disease. People with this condition may experience blurry vision, sensitivity to light, floaters, and night blindness.

In most people, it affects both eyes. It causes white or yellow lesions scattered around the retina that can damage the retina and affect the vitreous. Sarcoidosis is a kind of inflammation that can affect many parts of the body. Its cause is unknown. Acute retinal necrosis is a condition that often causes retinal detachment and vision loss. Signs may include red eyes, eye pain and hazy/blurry vision. Epstein-Barr virus (EBV) is a virus that infects nearly every adult. When infection with EBV occurs during adolescence or young adulthood, it often causes mono (mononucleosis). Behcet’s disease is a rare, chronic inflammatory disease. The cause of Behcet's disease is unknown. If often begins when individuals are in their 20s or 30s, although it can happen at any age. Uveitis is very common with people suffering from Behcet’s, which can cause acute uveitis that happens soon after onset of Behcet’s disease. Syphilis is a sexually transmitted disease. It can be cured, but if left untreated, the late stages of the disease can cause heart problems, abnormalities, mental illness, blindness and death.

Although on the decline over the past decade, it has seen more cases in recent years. APMPPE is an eye condition that can cause temporary loss of vision related to lesions that appear in part of the retina. The lesions usually heal after a few weeks. Serpiginous choroidopathy is related to uveitis – a rare condition that affects the part of the uvea called the choroid. It can affect the vitreous body and cause lesions on the retina that result in vision loss. Causes of Panuveitis As with other kinds of uveitis, the cause of panuveitis is often unknown. Other possible causes include: Sarcoidosis is a kind of inflammation that can affect many parts of the body. Its cause is unknown. Behcet’s disease is a rare, chronic inflammatory disease. The cause of Behcet's disease is unknown. If often begins when individuals are in their 20s or 30s, although it can happen at any age. Uveitis is very common with people suffering from Behcet’s, which can cause acute uveitis that happens soon after onset of Behcet’s disease.

Lupus is a chronic inflammatory disease that affects different parts of the body, including the skin, joints, blood, and kidneys and is related to the body’s immune system. Syphilis is a sexually transmitted disease. It can be cured, but if left untreated, the late stages of the disease can cause heart problems, abnormalities, mental illness, blindness and death. Although on the decline over the past decade, it has seen more cases in recent years. Vogt-Koyanagi-Harada syndrome is an inflammatory condition that involves the eyes and meninges (coverings of the brain). The condition is most common in Asians and American Indians. It often causes uveitis in both eyes and retinal detachments, and can result in serious vision loss and blindness. Tuberculosis (TB) is a disease caused by bacteria that usually attacks the lungs. TB disease was once the leading cause of death in the United States. It is spread through the air from one person to another. Although treatable, TB is still a problem in the U.S. Fungal Retinitis fungal infections can be a problem for people with weakened immune systems, including very premature babies and people with HIV or AIDS.

Causes of Uveitis in Children Children with uveitis, especially young children, may not know how to explain what they are experiencing, or they may not know anything is wrong until the uveitis has damaged their eyes and their vision. Often, the cause of the uveitis is unknown. Juvenile rheumatoid arthritis is a leading cause of uveitis in children. Certain genes may also be related to uveitis. Causes may include: Juvenile rheumatoid arthritis is defined as arthritis that causes inflammation and stiffness in joints lasting more than six weeks in a child under 16 years of age. Toxoplasmosis is an infection caused by a parasite. It affects up to one fifth of all adults in America. People may become infected from eating raw or undercooked meats, drinking unpasteurized milk, cleaning cat litter boxes, or working in gardens or playing in sandboxes that contain cat feces. Toxocariasis is a parasitic worm transmitted to people from dogs and cats. Children come into contact with the parasite when they play in sandboxes and on playgrounds contaminated with the parasite’s eggs. The worm’s larva can invade the eye and cause uveitis.

Sarcoidosis is a kind of inflammation that can affect many parts of the body. Its cause is unknown. Vogt-Koyanagi-Harada syndrome is an inflammatory condition that involves the eyes and meninges (coverings of the brain). The condition is most common in Asians and American Indians. It often causes uveitis in both eyes and retinal detachments, and can result in serious vision loss and blindness. Acute retinal necrosis is a condition that often causes retinal detachment and vision loss. Signs may include red eyes, eye pain and hazy/blurry vision. Reiter’s syndrome is an inflammatory arthritis common in young men – often caused by chlamydia infection. Lupus is a chronic inflammatory disease that affects different parts of the body, including the skin, joints, blood, and kidneys and is related to the body’s immune system. Behcet’s disease is a rare, chronic inflammatory disease. The cause of Behcet's disease is unknown. If often begins when individuals are in their 20s or 30s, although it can happen at any age.

Uveitis is very common with people suffering from Behcet’s, which can cause acute uveitis that happens soon after onset of Behcet’s disease. Fuch’s heterochromic iridocyclitis is a chronic kind of iritis. Its cause is unknown. It may cause rapid increase in eye pressure, requiring immediate treatment. Chicken pox is a common childhood illness. It occasionally causes serious side effects for children and people infected with the disease later in life. What Causes Vision Loss from Uveitis? Uveitis is a common cause of vision loss and blindness in the United States and in the world. Uveitis may cause blurry and reduced vision. When treated, vision may recover. In some cases, mostly in intermediate uveitis, posterior uveitis and panuveitis, where inflammation is recurrent and chronic, damage to the eye can occur, particularly to the retina and optic nerve, and cause permanent visual loss. Posterior Uveitis - NORD (National Organization for Rare Disorders) Posterior Uveitis Choroiditis General Discussion Uveitis is a general term that refers to inflammation of the part of the eye known as the uvea.

The uvea is a relatively thick, strong layer of fibrous tissue that encloses and protects the eyeball. It consists of three parts: the iris, the ciliary body, and the choroid. There are three types of uveitis, classified according to the part of the uvea that is affected. Anterior uveitis, which affects the front part of the eye, is also sometimes called iritis since the iris is part of the front of the eye. Intermediate uveitis, also known as pars planitis or cyclitis, refers to inflammation of tissues in the area just behind the iris and lens of the eye. Posterior uveitis, also known as choroiditis, refers to inflammation of the choroid, the back part of the uvea. Posterior uveitis may affect the retina and/or the optic nerve, and may lead to permanent loss of vision. Posterior uveitis is the rare form of the disorder and is the type of uveitis most associated with loss of vision. The other two forms are more common, and more frequently result in acute symptoms, but only rarely cause vision loss. Signs & Symptoms Posterior uveitis is usually, but not always, painless.

Symptoms typically include “floaters”, small specks, flakes, or clouds that move through the field of vision, and decreased vision. While anterior uveitis often causes eye pain and redness, light sensitivity, and blurred vision, the symptoms of posterior uveitis are more subtle. Uveitis can lead to other complications, including glaucoma, cataracts, or retinal detachment. Early detection and treatment is important to reduce the risk of permanent vision loss. Causes Posterior uveitis can have infectious or noninfectious causes. Infectious causes include bacterial, fungal, parasitic, and viral infections. Noninfectious causes include immunologic problems, allergies, malignancies, and unknown causes. One report suggests that about 60% of cases are caused by problems intrinsic to the eye itself and that the other 40% of cases are the result of associated autoimmune disorders, infections, and/or trauma. Some of the disorders with which posterior uveitis is sometimes associated are Behcet’s syndrome, ankylosing spondylitis, Lyme disease, sarcoidosis, and psoriasis. Among children, the disorder is frequently associated with juvenile rheumatoid arthritis.

Affected Populations Posterior uveitis occurs as an isolated condition or as part of other disease affecting body systems (systemic). This condition affects males and females in equal numbers. It can strike at almost any age, although it appears most often to occur between the ages of 20 and 50. According to one estimate, chronic, non-infectious posterior uveitis affects 175,000 people in the United States and 800,000 people worldwide. Almost 80% of cases of uveitis affect the front (anterior) portion of the eye. Related Disorders Symptoms of the following disorders can be similar to those of posterior uveitis. Comparisons may be useful for a differential diagnosis: Anterior uveitis is characterized by inflammation of the front (anterior) part of the eye. It is more common than is posterior uveitis, and its symptoms, which frequently include pain and redness of the eye, are not as subtle as those of posterior uveitis.

Intermediate uveitis, also known as Pars planitis, is a vision disorder characterized by inflammation of the peripheral retina and pars plana (a section of the ciliary body connected to the retina) sections of the eye. Fluid and foreign cells can infiltrate the clear gelatin-like substance (vitreous humor) near the retina and/or pars plana. Swelling inside the eye can also occur. These abnormalities may appear in one or both eyes. (For more information on this disorder, choose “Pars Planitis” as your search term in the Rare Disease Database.) Diagnosis The first step in diagnosis is to determine the role, if any, of other immunological and/or infectious conditions in the development of the disorder. Blood studies for infectious agents such as herpes virus, toxoplasmosis, toxocariasis and spirochetes are helpful. Chest x-rays may detect sarcoidosis or tuberculosis. If systemic or central nervous system involvement is present or large cell lymphoma is suspected, neuroimaging studies and lumbar puncture may be used. Standard Therapies Treatment It is important to identify and treat an underlying infection or immunological disorder before initiating other treatment.

Steroids administered intravenously are often used as a treatment for posterior uveitis. However, long-term use of systemic corticosteroids carries with it the risk of increased pressure in the eye (glaucoma) and cataracts, so the patient must be followed closely. In April of 2005, the FDA announced the approval of the orphan product Retisert (an implant) for the treatment of chronic, non-infectious posterior uveitis. The implant, a tiny drug reservoir, delivers approximately two-and-a-half years of the anti-inflammatory corticosteroid, fluocinolone acetonide, directly to the back of the eye. For information, contact the manufacturer: Bausch & Lomb For information about clinical trials sponsored by private sources, contact: Currently, the National Eye Institute is sponsoring clinical trials involving posterior uveitis. Two of these studies involve the use of a monoclonal antibody as a treatment for posterior uveitis. Monoclonal antibodies are genetically engineered proteins designed to affect a specific target or biochemical reaction within the body. In these trials, the monoclonal antibody is known as daclizumab and it inhibits a specific chemical reaction needed by lymphocytes to produce inflammation.

For information about these and other current trials, visit the ClinicalTrails.gov web site or contact the NIH Patient Recruitment Office (see above). NORD Member Organizations References TEXTBOOKS Wade NK, Seto RJ. Posterior Uveitis. In: The NORD Guide to Rare Disorders, Philadelphia: Lippincott, Williams and Wilkins, 2003:666. Beers MH, Berkow R., eds. The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999:725-29. Berkow R., ed. The Merck Manual-Home Edition.2nd ed. Whitehouse Station, NJ: Merck Research Laboratories; 2003:1305-06. Kanski JJ., ed. Clinical Ophthalmology. 4th ed. Butterworth-Heinemann. Oxford, UK; 1999:264-319. REVIEW ARTICLES Ciulla TA, Walker JD, Fong DS, et al. Corticosteroids in posterior segment disease: an update on new delivery systems and new indications.

Curr Opin Ophthalmol. 2004;15:211-20. Ciardella AP, Borodoker N, Costa DL, et al. Imaging the posterior segment in uveitis. Ophthamol Clin North Am. 2002;15:281-96. Okada AA. Drug therapy in Behcet’s disease. Ocul Immunol Inflamm. 2000;8:85-91. JOURNAL ARTICLES Menezo V, Lau C, Comer M, et al. Clinical outcome of chronic immunosuppression in patients with non-infectious uveitis. Clin Experiment Ophthalmol. 2005;33:16-21. Chen CS, Robertson D, Hammerton ME. Juvenile arthritis-associated uveitis: visual outcomes and prognosis. Can J Ophthalmol. 2004;39:614-20. Murphy CC, Greiner K, Plskova J, et al. Neutralizing tumor necrosis factor activity leads to remission in patients with refractory non-infectious posterior uveitis. Arch Ophthalmol.

2004;122:845-51. Erratum in: Arch Ophthalmol. 2004;122:1336. Lobo A, Barton K, Minassian D, et al. Visual loss in sarcoid-related uveitis. Clin Experiment Ophthalmol. 2003;31:310-16. Toker E, Kazokoglu H, Acar N. High-dose intravenous therapy for severe posterior segment uveitis in Behcet’s disease. Br J Ophthalmol. 2002;86:521-23. FROM THE INTERNET Years Published 1987, 1988, 1989, 1994, 2003, 2004, 2005 The information in NORD’s Rare Disease Database is for educational purposes only and is not intended to replace the advice of a physician or other qualified medical professional.

The content of the website and databases of the National Organization for Rare Disorders (NORD) is copyrighted and may not be reproduced, copied, downloaded or disseminated, in any way, for any commercial or public purpose, without prior written authorization and approval from NORD. Individuals may print one hard copy of an individual disease for personal use, provided that content is unmodified and includes NORD’s copyright. National Organization for Rare Disorders (NORD) 55 Kenosia Ave., Danbury CT 06810 • (203)744-0100 Report Index Uveitis | Retina Vitreous Associates Treatment What is Uveitis? Uveitis is inflammation of the part of the eye called the uvea. The uvea is the middle layer of the eye, between the innermost layer, the retina, and the outermost layer, the sclera. The uvea is composed of three parts: the iris, the ciliary body, and the choroid.

Because the blood vessels of the uvea nourish important parts of the eye, such as the retina, inflammation of the uvea can harm your sight and affect other parts of your eye, such as the lens, the retina, the optic nerve, and the vitreous. The source of your uveitis may be a problem or disease of the eye, or it may be the result of an inflammatory disease affecting other parts of your body. You may have infectious or non-infectious uveitis. While people of all ages can be affected by uveitis, it is most commonly seen in people between the ages of 20 and 60. Your board-certified retina specialist can determine whether you have uveitis. The four types of Uveitis Iritis: The most common type of uveitis, iritis affects the front (the anterior) of your eye. (Your retina specialist may also refer to iritis as anterior uveitis.) The onset is usually sudden, and the condition may last six to eight weeks. It is most common in young and middle-aged people who are often otherwise healthy, but some cases of uveitis are associated with rheumatologic, skin, gastrointestinal, lung and infectious diseases.

Pars planitis: Also called intermediate uveitis, this type is characterized by inflammation in the middle of the eye. Most often seen in young adults, the center of the inflammation tends to appear in the vitreous. It has been linked to several disorders, including sarcoidosis and multiple sclerosis. Pars planitis can last a few weeks or number of years, and goes through cycles of getting better, then worse. Posterior uveitis: This type can develop slowly and affects the back (the posterior) of your eye, often involving both the retina and the choroid. It is the least common form of uveitis and often lasts for many years. Panuveitis: All layers of the uvea are inflamed in this type of the disease. Behcet's disease is one of the most well-known forms of panuveitis, which severely damages the retina. What causes Uveitis? The body responds to insults like tissue damage and to "invaders" such as germs and toxins with inflammation. Inflammation causes swelling, redness, and heat, and destroys tissue as certain white blood cells rush to contain or eliminate the insult. When this inflammatory response occurs in the eye, we call it uveitis.

Uveitis (inflammation in your eye) may be caused by: An autoimmune condition (your body's own immune system attacks the body) Infections or tumors in the eye or in other parts of the body Bruises to the eye Toxins that enter the eye Diseases associated with Uveitis Uveitis can be a symptom of many diseases, including: AIDS Uveitis: What You Need to Know Treatment Uveitis is really a broad term for many problems with your eye. What they have in common is eye inflammation and swelling that can destroy eye tissues. That destruction can lead to poor vision or blindness. The word “uveitis” is used because the swelling most often affects the part of your eye called the uvea. Your eye is made of layers. The uvea is the middle layer. It’s right between the white part of your eye -- called the sclera -- and the inner layers of your eye. Your uvea contains three important structures: The iris: That’s the colored circle at the front of your eye. The ciliary body: Its job is to help your lens focus and keep it healthy. The choroid: This is a group of blood vessels that give your retina the nutrients it needs.

Are There Different Types of Uveitis? Yes. Which type you have depends on where the swelling is. Anterior uveitis is the most common. It affects the front of your eye. Intermediate uveitis affects your ciliary body. Posterior uveitis affects the back of your eye. If your entire uvea is inflamed, you have pan-uveitis . What Causes It? Many things, actually. They’re all tied to inflammation. For example, a toxic substance could get into your eye and cause inflammation. So could a bruise to your eye. Uveitis may also be caused by an autoimmune disease, meaning your body is attacking itself. That attack causes inflammation, and so do infections and tumors in your eye or other parts of your body. Are Some People at Greater Risk? Folks with certain gene combinations and those who smoke seem to be at greater risk. Some diseases also increase the chances, including: AIDS

Question: What part of the body is affected by Uveitis?
Answer: Eyes